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. 2022 Dec 1;14(12):e32096.
doi: 10.7759/cureus.32096. eCollection 2022 Dec.

Self-Expanding Metallic Stents for Palliation of Esophageal Cancer: A Single Center Experience From Saudi Arabia

Adnan Alzanbagi  1 , Laeeque A Qureshi  2 , Ishtiaq Ahmed  1 , Abdulaziz Tashkandi  1 , Mohammed Khan  1 , Ghaidaa A Alhazmi  3 , Mohammed K Shariff  1
Affiliations

Self-Expanding Metallic Stents for Palliation of Esophageal Cancer: A Single Center Experience From Saudi Arabia

Adnan Alzanbagi et al. Cureus. .

Abstract

Background: Self-expanding metallic stents (SEMSs) are increasingly used as a non-surgical alternative for the palliation of advanced esophageal cancer (EC). However, there is a scarcity of real-life experience with the use of these stents exclusively in EC. The aim of this study is to evaluate the efficacy of SEMS in inoperable ECs in the western region of Saudi Arabia.

Methods: A retrospective review of SEMS placed in a tertiary referral hospital for histologically proven inoperable EC from 2016 to 2019. Demographics data, procedure success, complication, re-intervention, and mortality were analyzed.

Results: Forty-eight SEMS placed in 35 patients for palliation of dysphagia. The median age of patients was 68 years (range 31-95). 69% (24) patients have a lower third of EC and the rest have a middle third. SEMSs were placed successfully in all cases with symptomatic improvement. No major stent-related complication was seen. 28% (13) patients required re-intervention with additional SEMS placement, nine of which were for tissue in growth and four for distal migration. Median survival was 114 days (range 30-498). Most of the complications seen in fully covered SEMS compared to the partially covered 50% (8/16) vs 17% (5/30), respectively, p = 0.04. Chemo and/or radiotherapy were given to 51% (18) of the patients without any significant benefit on survival (p = 0.79) or re-intervention rate (p = 0.47) compared to those who did not.

Conclusion: SEMS is effective in palliating dysphagia in inoperable EC without major complications. Rates of tumors in growth and migration were comparable to other studies. SEMS provides long-term palliation.

Keywords: cancer; ec- esophageal cancer; gastroenterology; palliation; self-expanding metallic stent.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Fluoroscopy with gastrograffin at the time of upper endoscopy
(A) There is a long segment distal esophageal luminal narrowing (dashed arrow) suggestive of esophageal cancer with proximal dilatation of the esophagus (double head arrow) with gastrograffin hold up and endoscope (solid arrow) in place. (B) Post stent insertion. Stent in situ with free flow of gastrograffin to stomach.
Figure 2
Figure 2. Reintervention rates depending on chemo-radiotherapy, gender, stent type and tumor location
Figure 3
Figure 3. Median survival depending on chemo-radiotherapy, gender, stent type and tumor location
See this image and copyright information in PMC

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